Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 0101-036383 | VA |
Y | 2080P0202X | Pediatric Cardiologist | 0101-036383 | VA |
NPI | 1164494159 |
---|---|
Provider Name | William Gay |
First Address | Roanoke, VA 24018-3833 |
Second Address | Roanoke, VA 24018-0720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2006 |
Last Update Date | 12/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6705677 | (05) | VA |
6712126 | (05) | VA |
6725066 | (05) | VA |
6736645 | (05) | VA |
6736785 | (05) | VA |
6736793 | (05) | VA |
6739831 | (05) | VA |
A72796 | (02) | VA |